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Rheumatoid Arthritis: Finger and Hand Surgeries

Topic Overview

There are several surgeries to correct joint problems in
the hand caused by
rheumatoid arthritis, including:

Carpal tunnel release, which involves releasing
or cutting a ligament in the wrist to relieve pressure on a nerve that runs
through the middle of the wrist and supplies feeling to the hand (median
nerve).

Tendon release, which may be used to treat abnormal bending
of fingers (flexion contractures).

Tendon repair, which may be used
to repair or reattach a tendon.

Synovectomy (removal of inflamed
tissue or synovium), which can ease pain. It is often combined with other
surgical procedures. It may also be done to reduce the risk of tendon damage
when inflammation of the tissue that lines the joints (synovium) is affecting
the tendons. The effect on long-term joint damage is
unclear.

Joint resurfacing, a procedure that replaces
damaged joint surfaces in the fingers with plastic or metal-and-plastic
coverings. This can restore more normal finger alignment, ease pain, and
improve function.

Total resection arthroplasty, in which the ends
of the joint bones are removed and replaced with metal and/or plastic
components.

Arthrodesis, a procedure in which the joints are
permanently fused together. This procedure severely limits motion, but it
usually relieves pain.

If surgery is needed on the wrist and fingers, the wrist is
usually done first. The position of tendons and other tissues in the wrist
determines the balance of the finger tendons. If several surgeries are needed
on the same hand, they may all be done at once.

The main goal of
surgery is to relieve pain and restore some minimal function that will allow
you to continue doing such basic activities as eating, bathing, and dressing.

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